The article “Does participation in the community outreach for asthma care and healthy lifestyles (COACH) program alter subsequent use of hospital services for children discharged with asthma?” appeared in the Journal of Asthma. It was written by Pinto, Navallo, and Petrova (2019). The purpose of the study was to define whether participation in COACH influenced the frequency of post-discharge hospital visits. While the article uses a diversified sample of sufficient size and addresses a significant problem, lack of experimental design and narrow focus means it can only be used in conjunction with other studies on the subject.
Research methods generally correspond to the task set by the authors. The study used a sample of 338 children between 6 months and 18 years (Pinto, Navallo, & Petrova, 2019). This sample is comparable in size to the one used by Mangiapan et al. (2018) and transcends the one used by Ly et al. (2019) in both size and diversity. It employed comparative effectiveness design “recognized as an important tool for evaluating the efficacy of clinical practice” (Pinto et al., 2019, p. 7).
The major limitation is the lack of experimental design, as the study participants chose whether to participate in Coach or not, and the researchers did not assign them to intervention and comparison groups manually. The authors attempted to overcome this limitation by standardizing the extraction tools and using regression tools “to control for potential confounders” (Pinto et al., 2019, p. 8). Still, this limitation affects the usefulness of the research, as the authors cannot account for the causal factors behind the composition of the intervention and comparison groups.
The authors found out that participation in COACH only had short-term effects. It correlated to a 50 percent reduction in readmissions during the first month after discharge but showed no difference in the use of hospital resources during the 12 months (Pinto et al., 2019). Thus, the authors provide new factual information on how participation in COACH correlates to the improvement of at least one quality indicator, which is a contribution to the knowledge of asthma management in children (Pinto et al., 2019). The study addresses a significant problem, because effective follow-up is essential for asthma in underage patients, as noted by Bush (2015) and Jat and Kabra (2019).
Still, the narrow focus on only one specific type of a follow-up – that is, the COACH program – limits the usefulness of the study and mandates using it together with other works in the field. The studies by Mangiapan et al. (2018) or Lv et al. (2019) generally support the conclusion that the nurse-administered follow-up in patients with asthma leads to a modest improvement in readmission rates. Thus, the study fits within the context of contemporary research in its field.
As one can see, the article by Pinto et al. (2019) contributes to the study of asthma management in children but is not free of downsides either. The strength of the research lies in a sample of sufficient size and variability that is comparable to or supersedes those used in other similar studies of recent years. Yet the lack of experimental design constitutes a major flaw only partially amended by the authors. The authors answer their research question successfully and broaden the knowledge of follow-up in underage patients with asthma. Still, the narrow focus and limitations of the study only make it useful in conjuncture with other works on the subject, which mostly confirm its findings.
References
Bush, A., & Fleming, L. (2014). Diagnosis and management of asthma in children. BMJ: British Medical Journal, 350.
Jat, K.R., & Kabra, S.K. Awareness about childhood asthma. Indian Journal of Medical Research, 145(5), 581-583.
Ly, S., Ye, X., Wang, Z., Xia, W., Qi, Y., Wang, W., …Qian, X. (2019). A randomized controlled trial of a mobile application‐assisted nurse‐led model used to improve treatment outcomes in children with asthma Journal of Advanced Nursing 75(11), pp. 3058-3067.
Mangiapan, J., Desmettre, T., Prud’Homme, A., Dalphin, J. C., Stach, B., Salmeron, S., & Plaisance, P. (2018). A nurse phone call educational program enhances health status of asthmatic patients after an emergency department of admission for acute exacerbation. European Respiratory Journal, 52. Web.
Pinto, J. M., Navallo, L. J., & Petrova, A. (2019). Does participation in the community outreach for asthma care and healthy lifestyles (COACH) program alter subsequent use of hospital services for children discharged with asthma? [Epub ahead of print]. Journal of Asthma. Web.